Cognitive training for freezing of gait in Parkinson's disease : a randomized controlled trial

Courtney C. Walton; Loren Mowszowski; Moran Gilat; Julie M. Hall; Claire O'Callaghan; Alana J. Muller; Matthew Georgiades; Jennifer Y. Y. Szeto; Kaylena A. Ehgoetz Martens; James M. Shine; Sharon L. Naismith; Simon J. G. Lewis

doi:10.1038/s41531-018-0052-6

Cognitive training for freezing of gait in Parkinson's disease : a randomized controlled trial

Courtney C. Walton, Loren Mowszowski, Moran Gilat, Julie M. Hall, Claire O'Callaghan, Alana J. Muller, Matthew Georgiades, Jennifer Y. Y. Szeto, Kaylena A. Ehgoetz Martens, James M. Shine, Sharon L. Naismith, Simon J. G. Lewis

Western Sydney University

Research output: Contribution to journal › Article › peer-review

63 Citations (Scopus)

Abstract

The pathophysiological mechanism of freezing of gait (FoG) has been linked to executive dysfunction. Cognitive training (CT) is a non-pharmacological intervention which has been shown to improve executive functioning in Parkinson's disease (PD). This study aimed to explore whether targeted CT can reduce the severity of FoG in PD. Patients with PD who self-reported FoG and were free from dementia were randomly allocated to receive either a CT intervention or an active control. Both groups were clinician-facilitated and conducted twice-weekly for seven weeks. The primary outcome was percentage of time spent frozen during a Timed Up and Go task, assessed both on and off dopaminergic medications. Secondary outcomes included multiple neuropsychological and psychosocial measures. A full analysis was first conducted on all participants randomized, followed by a sample of interest including only those who had objective FoG at baseline, and completed the intervention. Sixty-five patients were randomized into the study. The sample of interest included 20 in the CT group and 18 in the active control group. The primary outcome of percentage time spent frozen during a gait task was significantly improved in the CT group compared to active controls in the on-state. There were no differences in the off-state. Patients who received CT also demonstrated improved processing speed and reduced daytime sleepiness compared to those in the active control. The findings suggest that CT can reduce the severity of FoG in the on-state, however replication in a larger sample is required.

Original language	English
Article number	15
Number of pages	9
Journal	npj Parkinson's Disease
Volume	4
DOIs	https://doi.org/10.1038/s41531-018-0052-6
Publication status	Published - 2018

Open Access - Access Right Statement

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

Keywords

Parkinson's disease
gait disorders
movement disorders
older people
rehabilitation

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10.1038/s41531-018-0052-6

Cite this

Walton, C. C., Mowszowski, L., Gilat, M., Hall, J. M., O'Callaghan, C., Muller, A. J., Georgiades, M., Szeto, J. Y. Y., Ehgoetz Martens, K. A., Shine, J. M., Naismith, S. L., & Lewis, S. J. G. (2018). Cognitive training for freezing of gait in Parkinson's disease : a randomized controlled trial. npj Parkinson's Disease, 4, Article 15. https://doi.org/10.1038/s41531-018-0052-6

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abstract = "The pathophysiological mechanism of freezing of gait (FoG) has been linked to executive dysfunction. Cognitive training (CT) is a non-pharmacological intervention which has been shown to improve executive functioning in Parkinson's disease (PD). This study aimed to explore whether targeted CT can reduce the severity of FoG in PD. Patients with PD who self-reported FoG and were free from dementia were randomly allocated to receive either a CT intervention or an active control. Both groups were clinician-facilitated and conducted twice-weekly for seven weeks. The primary outcome was percentage of time spent frozen during a Timed Up and Go task, assessed both on and off dopaminergic medications. Secondary outcomes included multiple neuropsychological and psychosocial measures. A full analysis was first conducted on all participants randomized, followed by a sample of interest including only those who had objective FoG at baseline, and completed the intervention. Sixty-five patients were randomized into the study. The sample of interest included 20 in the CT group and 18 in the active control group. The primary outcome of percentage time spent frozen during a gait task was significantly improved in the CT group compared to active controls in the on-state. There were no differences in the off-state. Patients who received CT also demonstrated improved processing speed and reduced daytime sleepiness compared to those in the active control. The findings suggest that CT can reduce the severity of FoG in the on-state, however replication in a larger sample is required.",

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AU - Georgiades, Matthew

AU - Szeto, Jennifer Y. Y.

AU - Ehgoetz Martens, Kaylena A.

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AB - The pathophysiological mechanism of freezing of gait (FoG) has been linked to executive dysfunction. Cognitive training (CT) is a non-pharmacological intervention which has been shown to improve executive functioning in Parkinson's disease (PD). This study aimed to explore whether targeted CT can reduce the severity of FoG in PD. Patients with PD who self-reported FoG and were free from dementia were randomly allocated to receive either a CT intervention or an active control. Both groups were clinician-facilitated and conducted twice-weekly for seven weeks. The primary outcome was percentage of time spent frozen during a Timed Up and Go task, assessed both on and off dopaminergic medications. Secondary outcomes included multiple neuropsychological and psychosocial measures. A full analysis was first conducted on all participants randomized, followed by a sample of interest including only those who had objective FoG at baseline, and completed the intervention. Sixty-five patients were randomized into the study. The sample of interest included 20 in the CT group and 18 in the active control group. The primary outcome of percentage time spent frozen during a gait task was significantly improved in the CT group compared to active controls in the on-state. There were no differences in the off-state. Patients who received CT also demonstrated improved processing speed and reduced daytime sleepiness compared to those in the active control. The findings suggest that CT can reduce the severity of FoG in the on-state, however replication in a larger sample is required.

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ER -

Cognitive training for freezing of gait in Parkinson's disease : a randomized controlled trial

Abstract

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